$TXT Created by BAER,DAN at MHCVSS.FO-ALBANY.MED.VA.GOV (KIDS) on Tuesday, 06/20/06 at 09:25 ============================================================================= Run Date: JUL 31, 2006 Designation: LR*5.2*343 Package : LR - LAB SERVICE Priority: Mandatory Version : 5.2 SEQ #274 Status: Released Compliance Date: AUG 31, 2006 ============================================================================= Associated patches: (v)OR*3*141 <<= must be installed BEFORE `LR*5.2*343' (v)OR*3*142 <<= must be installed BEFORE `LR*5.2*343' Subject: PSI-05-068 ORDER DISCONTINUED ON PATIENT MOVE Category: - Routine - Data Dictionary - Other Description: ============ Blood Bank Team Coordination ============================ VISTA Laboratory Package patch LR*5.2*343 contains changes to software controlled by VHA DIRECTIVE 2004-058, titled VISTA BLOOD BANK SOFTWARE. Changes include: File #69.9 (Laboratory Site) Field #150.3 (CANCEL ON ADMIT) - Removed Field #150.4 (CANCEL ON DISCHARGE) - Removed Field #150.5 (CANCEL ON SPECIALTY TRANSFER) - Removed All of the above changes have been reviewed by the VISTA Blood Bank Developer and found to have no impact on the VISTA BLOOD BANK SOFTWARE control functions. RISK ANALYSIS: Changes made by patch LR*5.2*343 have no effect on Blood Bank software functionality, therefore RISK is none. EFFECT ON BLOOD BANK FUNCTIONAL REQUIREMENTS: Patch LR*5.2*343 does not alter or modify any software design safeguards or safety critical elements functions. POTENTIAL IMPACT ON SITES: This patch contains changes to 0 routines and 1 file identified in Veterans Health Administration (VHA) Directive 2004-058, group B listing. The changes have no effect on Blood Bank functionality or medical device control functions. There is no adverse potential to sites. VALIDATION REQUIREMENTS BY OPTION: There are no validation requirements for this patch. MINIMAL TEST CASE SCENARIOS BY OPTION, INCLUSIVE OF ALL CONTROL FUNCTIONS: There are no test case scenarios for this patch. ************************************************************************ Remove the LABORATORY package's rules for managing laboratory order auto-discontinuance on admission, transfer, or discharge events and let the existing rules in the OERR (ORDER ENTRY RESULTS REPORTING) package handle the order auto-discontinuance process. The LABORATORY package's process that is used to decide if an order should be discontinued when a patient move event is triggered will be disabled. This business rule is already being handled by the OERR package and the Lab's business rules do not perform all of the needed checks that the OERR package performs. For example, the Lab's process does not check that a new movement is actually tied to the current admission. An edit of a patient movement can result in erroneous auto discontinue of a patient's laboratory orders. OERR also provides checks in the software to establish whether the patient event is new or an edit to an existing event. The Lab's process has caused erroneous auto discontinuance of laboratory orders because it does not check if a new movement is actually tied to the patient's current admission. In the case outlined by the Patient Safety Issue (PSI) report it appeared that a user deleted and re-entered a movement for a prior admission to make a correction. Since it was a new movement the Lab code executed and the orders were discontinued. This problem would especially impact sites with patients that are transferred from the acute hospital to the nursing home. Technical Description ===================== When the DGPM MOVEMENT EVENTS of the PROTOCOL file (#101) is triggered the LR7O MOVEMENT EVENT protocol may be called (if it is an item of the DGPM MOVEMENT EVENTS protocol). In this situation the business rule processing in the LABORATORY package fails to make all of the needed checks to properly determine if the order should be discontinued. If Lab's logic discontinues the order there will be no order for OERR to apply its more detailed set of business rules against when the OERR code is called from the patient movement event. Lab will no longer perform any package-level checks for order auto-discontinuance based on patient movements. These checks will be performed by the OERR package. This change is accomplished by: Deletion of PROTOCOL file (#101) entries: LR7O MOVEMENT EVENT and LR7O MOVEMENT EVENT TASK Deletion of routine LR7OEVNT Deletion of the following Data Dictionary for LABORATORY SITE file (#69.9): CANCEL ON ADMIT field (#150.3) CANCEL ON DISCHARGE field (#150.4) CANCEL ON SPECIALTY TRANSFER field (#150.5) New Service Request: ==================== #20050802 -- Remove Lab Package Options to DC Order on Patient Movement Associated Remedy: ================== HD0000000104211 Associated E3R: =============== N/A Associated PSI: =============== PSI-05-068 Test Sites ========== DURHAM, NC -VAMC (Large site) NORTHERN CALIFORNIA HCS (Large site) ROUTINE SUMMARY =============== The following routines are included in this patch. The second line of each of these routines now looks like: ;; 5.2;LAB SERVICE;;Sep 27, 1994 Checksum Checksum Routine Name Before Patch After Patch Patch List LR343 N/A 12851791 343 LR7OEVNT 5021306 deleted by KIDS Routines deleted by KIDS: LR343,LR70EVNT List of preceding patches: n/a Sites should use CHECK^XTSUMBLD to verify checksums. PROTOCOLS LR7O MOVEMENT EVENT (deleted) LR7O MOVEMENT EVENT TASK (deleted) DATA DICTIONARIES LABORATORY SITE file (#69.9) CANCEL ON ADMIT field (#150.3) (deleted) CANCEL ON DISCHARGE field (#150.4) (deleted) CANCEL ON SPECIALTY TRANSFER field (#150.5) (deleted) INSTALLATION INSTRUCTIONS ========================= The install time for this patch is approximately 6 minutes. Suggested time to install: non-peak requirement hours. This patch can be installed when Laboratory users are on the system. I M P O R T A N T ============================= THIS INSTALLATION MUST BE QUEUED NOTE: Kernel patches must be current on the target system to avoid problems loading and/or installing this patch. Patch installation needs to be coordinated with the Laboratory Information Manager (LIM/ADPAC). 1. Use the "INSTALL/CHECK MESSAGE" option of the PackMan menu. This option will load the KIDS patch onto your system. 2. On the "Kernel Installation & Distribution System" Menu (KIDS), select the "Installation" menu. 3. Use the "Verify Checksum in Transport Global" option and verify that all routines have the correct checksums. 4. On the KIDS menu, under the "Installation" menu, use the following options: Print Transport Global Compare Transport Global to Current System Backup a Transport Global 5. Use the "Install Package(s)" option under the "Installation" menu and select the package "LR*5.2*343*" If prompted "Want KIDS to Rebuild Menu Trees Upon Completion of Install?" choose "NO". Note: Responding "Yes" to the prompt for rebuilding menu trees can significantly increase install time. If prompted "Want KIDS to INHIBIT LOGONs during the install?" choose "NO". If prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//" choose "NO" unless the site has additional local laboratory options that should be disabled during install. 6. When prompted for the DEVICE, enter "Q" to queue the build. If you do not queue the installation KIDS will abort the install. When you try to restart the install you may encounter an error due to a bug in KIDS. If this happens you will need to use FileMan to modify the INSTALL file (#9.7) for entry LR*5.2*343 which currently has the status of "Start of Install" and set its' STATUS field to "Install Completed". Reload the transport global and install the patch again. 7. Check your system for errors which may have occurred during the time this patch was installed. If the PROTOCOL DGPM MOVEMENT EVENTS was called during this patch installation, system errors (such as "Can't return to source" for routine LR7OEVNT) may have been generated. If so, those patient movements will have to be re- created. INSTALLATION EXAMPLE ==================== Select Installation Option: Install Package(s) Select INSTALL NAME: LR*5.2*343 Loaded from Distribution 10/20/05@12:39:58 => LR343 KIDS ;Created on Oct 20, 2005@11:59:59 This Distribution was loaded on Oct 20, 2005@12:39:58 with header of LR343 KIDS ;Created on Oct 20, 2005@11:59:59 It consisted of the following Install(s): LR*5.2*343 Checking Install for Package LR*5.2*343 Will first run the Environment Check Routine, LR343 Environment is okay Install Questions for LR*5.2*343 Want KIDS to INHIBIT LOGONs during the install? NO// Enter the Device you want to print the Install messages. You can queue the install by enter a 'Q' at the device prompt. Enter a '^' to abort the install. DEVICE: HOME// QUEUE TO PRINT ON DEVICE: HOME// P-MAIN Request Start Time: Oct 20, 2005@12:42:41// (OCT 20, 2005@12:42:41) Install Queued! Sample Installation Output ========================== Install Started for LR*5.2*343 : Oct 20, 2005@12:42:42 Build Distribution Date: Oct 20, 2005 Installing Routines:... Oct 20, 2005@12:42:42 Running Pre-Install Routine: PRE^LR343. Pre install started at Oct 20, 2005@12:42:42 Sent install started alert to mail group G.LMI Setting DISABLE and ACTION fields for Protocols No actions required for pre install Pre install completed at Oct 20, 2005@12:47:42 Installing PACKAGE COMPONENTS: Installing PROTOCOL... Oct 20, 2005@12:47:42 Running Post-Install Routine: POST^LR343. Post install started at Oct 20, 2005@12:47:42 File #69.9 field data update started File #69.9 field data deletion finished Post install completed at Oct 20, 2005@12:47:42 Sending install completion alert to mail group G.LMI Updating Routine file...... Updating KIDS files....... LR*5.2*343 Installed. Oct 20, 2005@12:47:42 Install Message sent Sample MailMan Message ====================== Pre install started at Oct 20, 2005@12:48:15 Sent install started alert to mail group G.LMI Setting DISABLE and ACTION fields for Protocols No actions required for pre install Pre install completed at Oct 20, 2005@12:48:55 Post install started at Oct 20, 2005@12:53:59 File #69.9 field data update started File #69.9 field data deletion finished Post install completed at Oct 20, 2005@12:54:45 Sending install completion alert to mail group G.LMI Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: LR343 Before: n/a After: B57547450 **343** Routine Name: LR7OEVNT Before: B9750943 After: Delete ============================================================================= User Information: Entered By : BAER,DAN Date Entered : AUG 19, 2005 Completed By: ELIJAH,VICKEY Date Completed: JUL 25, 2006 Released By : BELSCHWINDER,MICHAEL Date Released : JUL 31, 2006 ============================================================================= Packman Mail Message: ===================== $END TXT